压力高血糖比率与缺血性中风重症患者的短期和长期死亡率之间的关联
Haowei Pan1, Yiqun Xiong1, Yanming Huang1,2
1Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China.
Acta diabetologica
|March 19, 2024
概括
患有缺血性中风 (IS) 的重症监护病房患者的高压力高血糖比率 (SHR) 与短期和长期死亡率的增加有关. 这种关联无论糖尿病状况如何,都会持续存在,这突出显示了SHR是关键的预后指标.
科学领域:
- 神经学 神经学
- 内分泌学 在内分泌学.
- 关键护理医学 关键护理医学
背景情况:
- 住院高血糖症与缺血性中风 (IS) 患者的不良结果有关.
- 压力高血糖比率 (SHR) 是葡萄糖失调的标志物,需要在IS预后中进行调查.
- 了解SHR的影响,特别是关于糖尿病状况的影响,对于重症监护管理至关重要.
研究的目的:
- 为了评估压力高血糖比率 (SHR) 与重症监护室 (ICU) 严重IS患者的死亡率之间的关联.
- 确定糖尿病状况是否会改变IS患者中SHR和死亡率之间的关系.
- 评估与SHR相关的短期 (30天,90天) 和长期 (1年) 死亡风险.
主要方法:
- 使用密集护理医疗信息中心 (MIMIC-IV) 数据库,用于需要ICU入院的严重IS患者.
- 计算了所有纳入患者的压力高血糖比率 (SHR).
- 采用多变量考克斯回归和亚组分析,按糖尿病状况分层,以阐明SHR和死亡结果之间的关联.
主要成果:
- 分析了一组1376名严重IS患者的队列.
- 与最低四分位数 (Q1) 相比,增加的SHR (第三和第四四分位数) 与增加的30天,90天和1年死亡率显著相关.
- 高SHR与死亡率之间的关联在不同时间点一致,并且独立于糖尿病状况.
结论:
- 应激高血糖比 (SHR),以葡萄糖/HbA1c计算,是IS患者短期和长期死亡率增加的重要预测指标.
- 在IS患者中,SHR对死亡率的预测值独立于他们先前存在的糖尿病状况.
- SHR作为一个有价值的预后标记在临床护理环境中为缺血性中风患者服务.
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